NCLEX-RN
NCLEX Psychosocial Integrity Questions
1. Which psychosocial attribute plays an important role in the development of a healthy personality from birth to 1 year of age?
- A. Initiative versus guilt
- B. Trust versus mistrust
- C. Autonomy versus shame
- D. Industry versus inferiority
Correct answer: B
Rationale: According to Erikson's theory of psychosocial development, the first attribute that helps develop a healthy personality after birth is trust. Mistrust develops if the care provided to the infant is inconsistent. Initiative versus guilt is observed at 3 to 6 years of age, when children explore their surroundings and may experience guilt if their actions conflict with parental expectations. Autonomy versus shame occurs between 1 and 3 years of age, as children develop motor skills and new activities, with shame emerging if they feel self-conscious. Industry versus inferiority is evident in children aged 6 to 12 years, where successful task completion fosters a sense of industry, while excessive expectations can lead to feelings of inferiority. Therefore, the correct attribute for a healthy personality development from birth to 1 year of age is trust versus mistrust.
2. Which factor is most critical for a single mother of 2 children who recently lost her job and does not know what to do?
- A. Developmental history of children
- B. Available situational supports
- C. Underlying unconscious conflict
- D. Willingness to restructure lifestyle
Correct answer: B
Rationale: In a crisis intervention, the priority is to identify available situational supports, such as family, friends, community resources, and social services, that can help the single mother and her children during this difficult time. Understanding the developmental history of the children may be important to assess their needs, but it is not the most critical factor in this immediate crisis. Exploring underlying unconscious conflicts is more suited for long-term therapy rather than crisis intervention. While the willingness to restructure lifestyle may eventually be necessary, the immediate focus should be on finding support systems to address the current crisis.
3. A client admitted with a diagnosis of cervical cancer tells the nurse, 'I haven't had a Papanicolaou (Pap) smear for more than 8 years. I probably wouldn't be in the hospital today if I'd had those tests more often.' Which response would the nurse provide?
- A. ''Please tell me why you waited so long.''
- B. 'You feel as though you've neglected your health.''
- C. 'It's never too late to start taking care of yourself.''
- D. 'Most women hate to have Pap smears done, but they're really important.''
Correct answer: B
Rationale: The correct response, ''You feel as though you've neglected your health,'' is appropriate as it indicates recognition of expressed feelings, encouraging verbalization. This response is nondirective and reflective. Choice A, asking the client why she waited so long, ignores the client's current emotional needs and may cut off communication. Choice C, stating that it is never too late to start taking care of her health, is judgmental as it implies that the client has been negligent. Choice D, although acknowledging the importance of Pap smears, fails to address the client's current emotional state and needs.
4. The nurse is assessing a young client who presents with recurrent gastrointestinal disorders. On further assessment, the nurse learns that the client is experiencing job-related pressures. Which is the most important nursing intervention for this client?
- A. Educate the client on managing stress.
- B. Teach the client to maintain a balanced diet.
- C. Instruct the client to have regular health checkups.
- D. Ask the client to use sunscreen when working outdoors.
Correct answer: A
Rationale: The most important nursing intervention for a client experiencing job-related pressures and recurrent gastrointestinal disorders is to educate the client on managing stress. Stress is a lifestyle risk factor that can impact both mental health and physical well-being. It is associated with various illnesses, including gastrointestinal disorders. Teaching the client to maintain a balanced diet is important for preventive care and health promotion but is not the priority in this scenario. While instructing the client to have regular health checkups is essential for overall health maintenance, addressing the root cause of stress is crucial in this case. Asking the client to use sunscreen when working outdoors is important for sun protection and skin cancer prevention but not directly related to the client's job-related stress and gastrointestinal issues.
5. Which nurse statement defines boundaries in the orientation phase of the nurse-client relationship when talking to a depressed client who has just been admitted to the psychiatric unit?
- A. ''Tell me about the relationship that you have with your mother and father.''
- B. ''Hello! I'm Nurse Andrea. I'll introduce you around and help you settle in.''
- C. ''What is the main thing that you would like to work on during therapy?'
- D. ''I understand that you have been depressed. What can you tell me about that?'
Correct answer: B
Rationale: In the orientation phase of the nurse-client relationship, setting boundaries involves establishing the nurse's role and responsibilities while maintaining a professional distance. Option B demonstrates a clear boundary by introducing the nurse and offering assistance with settling in, which is appropriate for the initial phase of building rapport with the client. Choices A, C, and D delve into personal or therapeutic topics that are more suitable for the working phase of the relationship when the client's goals and problems are being addressed. Asking about the client's family relationships (Choice A), therapy focus (Choice C), or delving into the client's depression (Choice D) would be more relevant in later stages of the therapeutic process, once trust and rapport have been established during the orientation phase.
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